There's been a lot of talk here and elsewhere about callous, mean or stupid doctors. An article in the Times today has a pretty good discussion of the topic. They also provide a link to a site where patients can rate their doctors.
I have mixed feelings about the rating site. I think it's a great idea in general, and I believe it has the potential to change physician behavior. However, it's not at all clear that it's reliable in any meaningful way. First, you can't tell who is managing the site (and whoever it is, they don't proofread carefully). Second, the site allows advertising, which makes me suspicious. Third, it doesn't appear that they vet the ratings at all. I tried it out by rating one of my doctors; I was able to do this without creating an account, and my rating appeared instantly. There is a way to flag ratings or listings you feel are suspect, but since it's entirely anonymous, there's no way to tell if someone has, for instance, padded his or her own rating. (No, I didn't rate myself.) Finally, I expect the site will be heavy on the doctors that serve the educated (and in my opinion overtreated) patients who have easy access to the web. Most of my patients won't have the opportunity to make use of it.
But it's a start, and perhaps will help doctors start thinking about whether they are being good instead of whether they might be sued.
Wednesday, November 30, 2005
Tuesday, November 22, 2005
Shh, He'll Hear You
HellBoy is starting to talk more, but his pronunciation stinks. The other day GoodCat wandered into the living room and HB started his usual "AT! AT! AT!"
"HB, can you say 'CAT'?" TrophyHusband asked.
"AT!"
"CAT."
"AT!"
Just then the cat started to do what cats are wont to do, and TH, getting bored of the lesson, said, "Can you say, 'The cat is licking his balls'?"
And HB shouted, "BALLS!!!!"
He also calls spoons "poon." We're going to start getting dirty looks at daycare if we're not more careful.
"HB, can you say 'CAT'?" TrophyHusband asked.
"AT!"
"CAT."
"AT!"
Just then the cat started to do what cats are wont to do, and TH, getting bored of the lesson, said, "Can you say, 'The cat is licking his balls'?"
And HB shouted, "BALLS!!!!"
He also calls spoons "poon." We're going to start getting dirty looks at daycare if we're not more careful.
Saturday, November 19, 2005
And Some of My Best Friends Are Lawyers
Seems like I've been reading an awful lot of comments on other blogs lately in which the prevailing sentiment is that doctors are stupid and evil. Whenever someone has a story about some medical treatment that went wrong, usually in fertility treatment or childbirth, there are a bunch of comments insisting that the blogger should call a lawyer.
These comments leaves me feeling frustrated and a bit depressed. For the obvious reason, of course, but also because I think they illustrate a basic problem in healthcare in this country. There's this notion that if all doctors do their jobs right, everyone will be cured/get pregnant/give birth easily without drugs/have a healthy happy baby who sleeps through the night and never spits up.
There are few great doctors and a few bad doctors, and lots and lots of average doctors. But there is no doctor who will do the right thing all the time. And even when doctors do everything right, things will turn out wrong sometimes.
If things don't turn out perfectly, people often want to sue. But lawyers will not take most of these cases. Lawyers will only take the cases that will result in large monetary verdicts. These cases are the ones where someone is either killed or permanently physically damaged. The younger and cuter the patient is, the bigger the verdict.
So what does this system create? First, an environment in which doctors are afraid to admit when they have done something wrong, and therefore do not have any opportunity to teach others how to avoid mistakes. Second, a healthcare system that puts huge resources toward trying to avoid the outcomes that result in the largest awards -- efforts that are focussed on the minority of patients -- and little to no resources toward basic improvements that will benefit the majority of patients.
Take childbirth, for instance. An injured or dead newborn, whether the result of bad medical care or just bad luck, can result in an enormous jury award. The typical argument in these cases is that if the mother had received more aggressive medical care, the outcome could have been avoided. The obvious result of this is that OBs are under intense pressure to be aggressive all the time. Meaning, they quickly pressure women into induction, forceps, c-sections. They know they will not be successfully sued for bullying, but they could be sued for being gentle.
A lot of women turn to midwives because they know or sense this. Which can work ok, but midwives are also under pressure: they must quickly turn care over to the OBs if things start going south. And a doctor who suddenly has to pick up a tough case from a midwife, a doctor who doesn't know the patient or the whole story, is going to be even more aggressive than usual.
In the meantime, all of the things that can make childbirth in a hospital frightening, isolating, and frustrating are not addressed, because there's no money in it. There's no lawyer who will sue a hospital for arbitrary rules about visitors, for surly and overworked nurses, for failing to do everything possible to ensure breastfeeding success. And there's no insurance company that will reimburse hospitals for any of those things either.
I'm not defending bad doctors or crappy hospitals. I've been through my fair share of them myself, and it's awful. I do believe that sometimes suing is very appropriate. But I wish that everyone who is angry about the ways things are in healthcare right now -- and we should be angry -- would start thinking about what will actually make things better, and the answer is not to call a lawyer.
These comments leaves me feeling frustrated and a bit depressed. For the obvious reason, of course, but also because I think they illustrate a basic problem in healthcare in this country. There's this notion that if all doctors do their jobs right, everyone will be cured/get pregnant/give birth easily without drugs/have a healthy happy baby who sleeps through the night and never spits up.
There are few great doctors and a few bad doctors, and lots and lots of average doctors. But there is no doctor who will do the right thing all the time. And even when doctors do everything right, things will turn out wrong sometimes.
If things don't turn out perfectly, people often want to sue. But lawyers will not take most of these cases. Lawyers will only take the cases that will result in large monetary verdicts. These cases are the ones where someone is either killed or permanently physically damaged. The younger and cuter the patient is, the bigger the verdict.
So what does this system create? First, an environment in which doctors are afraid to admit when they have done something wrong, and therefore do not have any opportunity to teach others how to avoid mistakes. Second, a healthcare system that puts huge resources toward trying to avoid the outcomes that result in the largest awards -- efforts that are focussed on the minority of patients -- and little to no resources toward basic improvements that will benefit the majority of patients.
Take childbirth, for instance. An injured or dead newborn, whether the result of bad medical care or just bad luck, can result in an enormous jury award. The typical argument in these cases is that if the mother had received more aggressive medical care, the outcome could have been avoided. The obvious result of this is that OBs are under intense pressure to be aggressive all the time. Meaning, they quickly pressure women into induction, forceps, c-sections. They know they will not be successfully sued for bullying, but they could be sued for being gentle.
A lot of women turn to midwives because they know or sense this. Which can work ok, but midwives are also under pressure: they must quickly turn care over to the OBs if things start going south. And a doctor who suddenly has to pick up a tough case from a midwife, a doctor who doesn't know the patient or the whole story, is going to be even more aggressive than usual.
In the meantime, all of the things that can make childbirth in a hospital frightening, isolating, and frustrating are not addressed, because there's no money in it. There's no lawyer who will sue a hospital for arbitrary rules about visitors, for surly and overworked nurses, for failing to do everything possible to ensure breastfeeding success. And there's no insurance company that will reimburse hospitals for any of those things either.
I'm not defending bad doctors or crappy hospitals. I've been through my fair share of them myself, and it's awful. I do believe that sometimes suing is very appropriate. But I wish that everyone who is angry about the ways things are in healthcare right now -- and we should be angry -- would start thinking about what will actually make things better, and the answer is not to call a lawyer.
Monday, November 14, 2005
Interview Season
They're here. November through January is resident interview season, and they appear like a flock of black-suited birds migrating for the winter. I interview four in a row every interview day, and although we've only had two days so far, they're already starting to blur together. Same clothes (conservative), same hair (ditto), same questions ("How are the fellowship opportunities here?" "What changes are in store for your institution?") I desperately search their personal statements for something interesting to talk about, but I find the same statement every time:
Afterward they all send the same thank-you note, as they were instructed to do by their medical school. So how can I be expected to keep them straight? How I wish they would leave their hair long, wear a purple suit or a nose ring, talk about politics or a broken heart or religion or the kids they hope to have. I know it's scary for them -- for the ones with so-so academic records, anyway -- but it makes me sad to see them so conformed.
I know there are some medical students reading this. When you go on your interviews, give me a break. Wear green -- or at least gray or brown. Ask, "What do you love about your job? What do you love about your life?" And if the above is your personal statement, throw it away and start over. It's not so hard -- just talk. Tell me what makes you you.
ADDENDUM: jgt asked,
It depends on the specialty. In most surgical specialties (General, Plastics, Ortho, Urology, Ophtho), yes, they're relatively conservative, for doctors anyway. (In my unscientific investigations, doctors in general are more socially liberal than those in other professions, but surgeons tend to vote Republican whereas the non-surgical types are more often Democrats.) Peds, Family Practice, EM, and Internal Medicine are all fairly liberal groups, and Psychiatry is waaay out there groovy. (I'm not sure about Neurology and Dermatology; OB/Gyn is a mixed bag.)
Am I less conservative than average? Oh yeah -- I'm pretty much a lefty -- but a majority of my colleagues do agree with me on issues like abortion, the war, same-sex marriage, universal healthcare.
I certainly wouldn't advise anyone to try to be deliberately wacky to try to stand out from the crowd -- that's sure to backfire -- but hiding what's interesting about you seems like a bad idea too. What I'd do if I were on the interview trail today is try to get the interviewer talking first -- ask about a picture on their wall, maybe -- and get a sense of what they're like. If you have anything in common, start talking about that, and everything is easy after that. I love talking cats, kids, running, travel, photography, art, politics ... it's easy to get me going on any of it, and I'm not a very schmoozy person. Other colleagues would love to talk about cooking, sailing, biking, gardening, dogs, oh, I don't know. But if you don't start talking about something like that, you'll end up talking about how your worst quality is "my perfectionism!" and getting asked dumb questions like, "if you had to be the only doctor on a desert island, what two texts would you bring?"
The folks I remember clearly from last season were: the professional guitarist, the guy who drove ATVs during his every free moment, the guy from Ireland, the woman who had a baby the same age as mine (and was worried about even mentioning it in interviews), the guy whose parents immigrated to the U.S. and picked crops to get him through college, the almost certainly gay guy who directed an a capella choir with a cute name, the nine-months-pregnant woman, the professional surfer, the woman in a short skirt and spike-heeled boots ... if there'd been a juggler, I'd certainly have remembered him. And at the rank meeting months later, it wasn't hard to call these people to mind, unlike the rest of the plodding masses.
I walked through the doors of [name of free clinic / institute in a developing country / hospital in a bad section of town] with [appropriately humble emotion]. I was faced with [appalling scene of human hardship / touching scene of expected death / inspiring scene of personal courage]. I knew then that I wanted to [help others / make a difference].
When I was [age between 10 and 20], my [rather distant relative] fell ill with [not especially concerning illness]. Watching [him / her] suffer made me realize the impact of illness on others.
During my medical school career, I have volunteered at [a free clinic / a highschool to talk about contraception / an elementary school to tutor youth]. This has taught me the vital importance of [giving of oneself / feeling grateful for my position in life].
I will never forget the face of my first patient to [call me "doctor" / ask me to hold their hand / die]. I hope I will always remember the important lesson this taught me about [trust / empathy / death].
Ten years from now, I see myself as a practicing physician who is also involved in research in some way and who teaches students and residents, but I will never forget the feeling I had that first day I walked through the doors of [name of free clinic / institute in a developing country / hospital in a bad section of town] and really [felt like a doctor / understood what it means to be human].
Afterward they all send the same thank-you note, as they were instructed to do by their medical school. So how can I be expected to keep them straight? How I wish they would leave their hair long, wear a purple suit or a nose ring, talk about politics or a broken heart or religion or the kids they hope to have. I know it's scary for them -- for the ones with so-so academic records, anyway -- but it makes me sad to see them so conformed.
I know there are some medical students reading this. When you go on your interviews, give me a break. Wear green -- or at least gray or brown. Ask, "What do you love about your job? What do you love about your life?" And if the above is your personal statement, throw it away and start over. It's not so hard -- just talk. Tell me what makes you you.
ADDENDUM: jgt asked,
My husband is making the interview rounds right now. They're told over and over that the majority of attendings are conservative folk and that anything that makes you stick out is more likely to tip the scales against you than for you.
Do you think you're less conservative than the average attending?
It depends on the specialty. In most surgical specialties (General, Plastics, Ortho, Urology, Ophtho), yes, they're relatively conservative, for doctors anyway. (In my unscientific investigations, doctors in general are more socially liberal than those in other professions, but surgeons tend to vote Republican whereas the non-surgical types are more often Democrats.) Peds, Family Practice, EM, and Internal Medicine are all fairly liberal groups, and Psychiatry is waaay out there groovy. (I'm not sure about Neurology and Dermatology; OB/Gyn is a mixed bag.)
Am I less conservative than average? Oh yeah -- I'm pretty much a lefty -- but a majority of my colleagues do agree with me on issues like abortion, the war, same-sex marriage, universal healthcare.
I certainly wouldn't advise anyone to try to be deliberately wacky to try to stand out from the crowd -- that's sure to backfire -- but hiding what's interesting about you seems like a bad idea too. What I'd do if I were on the interview trail today is try to get the interviewer talking first -- ask about a picture on their wall, maybe -- and get a sense of what they're like. If you have anything in common, start talking about that, and everything is easy after that. I love talking cats, kids, running, travel, photography, art, politics ... it's easy to get me going on any of it, and I'm not a very schmoozy person. Other colleagues would love to talk about cooking, sailing, biking, gardening, dogs, oh, I don't know. But if you don't start talking about something like that, you'll end up talking about how your worst quality is "my perfectionism!" and getting asked dumb questions like, "if you had to be the only doctor on a desert island, what two texts would you bring?"
The folks I remember clearly from last season were: the professional guitarist, the guy who drove ATVs during his every free moment, the guy from Ireland, the woman who had a baby the same age as mine (and was worried about even mentioning it in interviews), the guy whose parents immigrated to the U.S. and picked crops to get him through college, the almost certainly gay guy who directed an a capella choir with a cute name, the nine-months-pregnant woman, the professional surfer, the woman in a short skirt and spike-heeled boots ... if there'd been a juggler, I'd certainly have remembered him. And at the rank meeting months later, it wasn't hard to call these people to mind, unlike the rest of the plodding masses.
Friday, November 11, 2005
The Human Binky: The Downside of Cosleeping
I had to stay at work until 9:00 last night for my "leadership" course ("Goal Setting" and "Attitudes for Success" were the topics last night. My Goal = Endure This Class; My Attitude = Truculence). HellBoy was still awake when I got home, of course, since our bedtime routine is: mama nurses him until he falls asleep. That was fine -- I was happy to be able to at least see him. But starting at about 3am, he decided that he couldn't sleep unless one of my breasts was in his mouth at all times. I don't know if it's related to my being gone last night, but I hope so, because I can't take too many nights of that. It would be one thing if I had long floppy dugs that I could just sling over to him on demand instead of tiny compact ones that necessitate much contortion on my part. My neck is stiff and I'm feeling groggy.
An another subject, you know what there should be a word for? You know how when you have to pee for a really long time but don't, and then finally you go, and for about a half hour after you go your bladder feels all happy to be empty? It's more than relief. There should be a word for that happy-empty-bladder-feeling.
An another subject, you know what there should be a word for? You know how when you have to pee for a really long time but don't, and then finally you go, and for about a half hour after you go your bladder feels all happy to be empty? It's more than relief. There should be a word for that happy-empty-bladder-feeling.
Monday, November 07, 2005
I Know I Should Love Them All the Same, But ...
There are patients I enjoy, and patients I enjoy less. Oh, who am I kidding, trying to be all PC. There are patients I can't stand. I have something of heirarchy when it comes to how much I like patients. I think most clinicians do, though the order can be very different.
At the top are the smart patients. Not educated, smart. They can be smart and follow all my directions, or they can be smart and ignore everything I say. I don't care. In fact sometimes the latter are the most interesting. I have one patient who smokes two packs a day and coughs and wheezes like a sick cat. I tell him to quit smoking, and he tells me, "Now you know I'm not going to do that!" But he doesn't ask me to fix his cough. He just comes to chat, and I love to chat with him.
Next are the crazy patients, provided that they aren't dangerous crazy. I didn't used to mind dangerous crazy, but one punched me in the face once and split my lip, so I'm a little more careful these days. (He wasn't my patient, by the way -- he was just walking by me in the psych ward and didn't like the looks of me.) (I always feel compelled to add this. Otherwise I'm afraid everyone will think I'm just annoying as hell and that I make my patients want to punch me in the face.)
Next are the dumb patients who do what I say. Boring and a little scary, these people.
Last are the dumb patients who ignore everything I say. God how I hate these folks. I have one guy who is cheating on his wife and keeps coming in for STD's and wants me to give him pills to slip to his wife in her food. (No, of course I don't give them to him!) (Should I?)
The other day I saw a woman who is five feet tall and 300 pounds. She said the same thing that 99.9% of really fat people say when the subject of weight comes up:
"I don't know why I keep gaining weight. I don't eat anything."
Now, this statement in itself is not the dumb part. Like I said, 99.9% of people say this. But I have a stock response that works 99.9% of the time:
"You may be right, and it's not fair, but however much you eat, it's too much for you."
Most people will nod sadly on hearing this. And it's not a line on my part; hyper people who jump around all day and jiggle their legs until the person sitting next to them on the couch screams "Would you cut it out?" can eat a lot more than serene folks. And most of the people on the planet are the product of generations of surviving starvation -- that Pack It On gene is powerful. I do practice what I preach -- I exercise, I don't drink soda and juice all day, and I try to avoid eating a lot of junk -- but I know that I have it easier than many people. For a lot of people, telling them to eat less is like telling them to breathe less. Especially in our society, with a Starbuck's and a McDonald's on every corner.
But this woman wasn't buying it. She stared at me for a long, long, moment, and said,
"No, I don't eat too much."
I was flummoxed. Finally I said, "Well, why do you think you gain weight?"
"Because there's something wrong. You need to do tests."
OK. A lot of people think thyroid disease can make you gain weight. And it can. But it can make you gain 15, 20 pounds, max. Not 180 pounds. But she didn't even think it was her thyroid, because her thyroid had already been tested multiple times. She believed that there was some other condition that was making her gain weight and that I hadn't tested her for this condition because I was either incompetent and didn't know about it, or evil and deliberately withholding it from her.
Oh, and I also needed to do tests to find out why her back hurts. And her knees.
I'd like to think I treat all my patients equally, but I know that's not possible. I have a pretty good poker face, but I'm sure my expression was less than entirely nonjudgmental and empathetic as I tried to explain to her that I was not withholding some magic treatment for obesity from her. And I offered her pills for weight loss. I don't mind doing this. They don't work very well, but I'm happy to have people try them. But she didn't want that. She wanted to know what was Wrong.
It reminded me of those plants -- you know, "Magic Plant! It Grows On Air!!!!" She could be a "Magic Human! She Absorbs Fat from the Atmosphere!!!!"
At the top are the smart patients. Not educated, smart. They can be smart and follow all my directions, or they can be smart and ignore everything I say. I don't care. In fact sometimes the latter are the most interesting. I have one patient who smokes two packs a day and coughs and wheezes like a sick cat. I tell him to quit smoking, and he tells me, "Now you know I'm not going to do that!" But he doesn't ask me to fix his cough. He just comes to chat, and I love to chat with him.
Next are the crazy patients, provided that they aren't dangerous crazy. I didn't used to mind dangerous crazy, but one punched me in the face once and split my lip, so I'm a little more careful these days. (He wasn't my patient, by the way -- he was just walking by me in the psych ward and didn't like the looks of me.) (I always feel compelled to add this. Otherwise I'm afraid everyone will think I'm just annoying as hell and that I make my patients want to punch me in the face.)
Next are the dumb patients who do what I say. Boring and a little scary, these people.
Last are the dumb patients who ignore everything I say. God how I hate these folks. I have one guy who is cheating on his wife and keeps coming in for STD's and wants me to give him pills to slip to his wife in her food. (No, of course I don't give them to him!) (Should I?)
The other day I saw a woman who is five feet tall and 300 pounds. She said the same thing that 99.9% of really fat people say when the subject of weight comes up:
"I don't know why I keep gaining weight. I don't eat anything."
Now, this statement in itself is not the dumb part. Like I said, 99.9% of people say this. But I have a stock response that works 99.9% of the time:
"You may be right, and it's not fair, but however much you eat, it's too much for you."
Most people will nod sadly on hearing this. And it's not a line on my part; hyper people who jump around all day and jiggle their legs until the person sitting next to them on the couch screams "Would you cut it out?" can eat a lot more than serene folks. And most of the people on the planet are the product of generations of surviving starvation -- that Pack It On gene is powerful. I do practice what I preach -- I exercise, I don't drink soda and juice all day, and I try to avoid eating a lot of junk -- but I know that I have it easier than many people. For a lot of people, telling them to eat less is like telling them to breathe less. Especially in our society, with a Starbuck's and a McDonald's on every corner.
But this woman wasn't buying it. She stared at me for a long, long, moment, and said,
"No, I don't eat too much."
I was flummoxed. Finally I said, "Well, why do you think you gain weight?"
"Because there's something wrong. You need to do tests."
OK. A lot of people think thyroid disease can make you gain weight. And it can. But it can make you gain 15, 20 pounds, max. Not 180 pounds. But she didn't even think it was her thyroid, because her thyroid had already been tested multiple times. She believed that there was some other condition that was making her gain weight and that I hadn't tested her for this condition because I was either incompetent and didn't know about it, or evil and deliberately withholding it from her.
Oh, and I also needed to do tests to find out why her back hurts. And her knees.
I'd like to think I treat all my patients equally, but I know that's not possible. I have a pretty good poker face, but I'm sure my expression was less than entirely nonjudgmental and empathetic as I tried to explain to her that I was not withholding some magic treatment for obesity from her. And I offered her pills for weight loss. I don't mind doing this. They don't work very well, but I'm happy to have people try them. But she didn't want that. She wanted to know what was Wrong.
It reminded me of those plants -- you know, "Magic Plant! It Grows On Air!!!!" She could be a "Magic Human! She Absorbs Fat from the Atmosphere!!!!"
Wednesday, November 02, 2005
Only Ghosts Need Apply
This being our first year in our house, I wasn't sure how much candy we'd need for Halloween. So last week when I saw our neighbor from two doors up the street, who's been here forever, and whose house was decked out in Halloween-themed decorations, I asked her. And something kind of strange happened.
"Ah ... er ... well, for years we did ours on the Sunday before Halloween," she said. "But I'm not sure what the plan is this year ..."
I was confused. Halloween before Halloween? She explained that there is a tradition on our block to have Halloween early, just for our block. And then many people turn off their lights on the 31st.
Huh.
It took me a minute. What would be the benefit in this? Well, your kids would only go to houses of people you sort of know ... but wait, you could do that just as well on Halloween itself, right? So the only benefit is, you wouldn't have to answer your door for the people who aren't on your street. And what, you might ask, is the difference between the people on our street and the people, oh, a couple of blocks over?
Exactly. Our neighborhood is racially mixed. Our street, not very.
I'm kind of slow. I didn't actually figure it out until after our neighbor left, but once I did, I was livid. And embarrassed to be living on this block. It's not the kind of thing one asks when going to an open house. And there were Kerry stickers all over the place. But I can't say that I didn't know about the general paleness of our neighbors.
Fortunately our neighborhood has a listserve, which we consulted. We found that we weren't the only ones who felt that this was racist, and everyone -- at least, everyone who was willing to post about it -- agreed that they would indeed be doing Halloween on Halloween. Still, on Sunday, there were some kids on our block going door to door and some people answering the door with candy.
But on Halloween we sat on our stoop with beer (for us) and candy (for the trick or treaters) and you know what? We had a blast. There were a lot of dark houses on the block, but also a lot with their lights on, and lots of people sitting on their stoops, and it was a big party. (The neighbor who told me about the Sunday thing was out on her stoop too.) AngelBaby had a ball watching the parade of kids. I only had to chase after him once, when he fell in love with a dog and wanted to follow it home. We took pictures of the kids, and even printed a few pictures on the spot to give to them -- it was like some corny TV ad.
This is what some people were afraid to open their doors for. And this. And this.
"Ah ... er ... well, for years we did ours on the Sunday before Halloween," she said. "But I'm not sure what the plan is this year ..."
I was confused. Halloween before Halloween? She explained that there is a tradition on our block to have Halloween early, just for our block. And then many people turn off their lights on the 31st.
Huh.
It took me a minute. What would be the benefit in this? Well, your kids would only go to houses of people you sort of know ... but wait, you could do that just as well on Halloween itself, right? So the only benefit is, you wouldn't have to answer your door for the people who aren't on your street. And what, you might ask, is the difference between the people on our street and the people, oh, a couple of blocks over?
Exactly. Our neighborhood is racially mixed. Our street, not very.
I'm kind of slow. I didn't actually figure it out until after our neighbor left, but once I did, I was livid. And embarrassed to be living on this block. It's not the kind of thing one asks when going to an open house. And there were Kerry stickers all over the place. But I can't say that I didn't know about the general paleness of our neighbors.
Fortunately our neighborhood has a listserve, which we consulted. We found that we weren't the only ones who felt that this was racist, and everyone -- at least, everyone who was willing to post about it -- agreed that they would indeed be doing Halloween on Halloween. Still, on Sunday, there were some kids on our block going door to door and some people answering the door with candy.
But on Halloween we sat on our stoop with beer (for us) and candy (for the trick or treaters) and you know what? We had a blast. There were a lot of dark houses on the block, but also a lot with their lights on, and lots of people sitting on their stoops, and it was a big party. (The neighbor who told me about the Sunday thing was out on her stoop too.) AngelBaby had a ball watching the parade of kids. I only had to chase after him once, when he fell in love with a dog and wanted to follow it home. We took pictures of the kids, and even printed a few pictures on the spot to give to them -- it was like some corny TV ad.
This is what some people were afraid to open their doors for. And this. And this.
Friday, October 28, 2005
The First Hit Is Free, Then You Have to Pay
We flew across the country last week so that I could attend a conference and TrophyHusband could spend time with some college friends who have a five-month-old little girl. This trip posed a challenge: How to survive six hours in an airplane with HellBoy?
On the trip out, we made use of:
However, my guilt didn't last long. It would seem that HB has inherited a hardy liver from his mother. Because although he did settle in for a nap about 45 minutes after his dose, the nap didn't last much longer than his usual one, at which point he awoke, extra rested for his next assault. And then we entered some turbulence. The stewardess, who was either very rules-conscious or just sadistic, insisted that the seatbelt sign applied to HB as well, and he had to be strapped into his carseat.*
And then his DVD player, which apparently was not designed to survive being repeatedly hurled to the floor, broke.
How bad did it get? So bad that we actually had notes passed up the aisle with suggestions from other passengers on how to make him shut up. And I couldn't blame them. I actually hoped someone might have a good idea. But really, all he wanted was Out. Of. This. Frickin. Seat.
There was no evidence that the Benadryl had any lasting effect whatsoever. And when we got home he wouldn't go to sleep until 11:30. I guess next time we slip him some Xanax, or on second thought, take it ourselves and then offer it around the plane.
*This highlights the weird double standard about babies and airplanes. If they're under two, they can sit on your lap. Ah, they'll be fine, just hang on to 'em. We tend to get a seat for HB anyway, since we risk bodily injury if we try to control him within the confines of our two seats. But if we buy him a seat and bring his carseat, then they get all official on our asses. First they have to check if the seat is Approved, and then they make him sit in it. WTF?
On the trip out, we made use of:
- puppets
- a beachball
- soap bubbles
- breasts
- candy
- dvds
- singing
- books
- friendly stewardesses, and
- many, many, many trips up and down the aisle
- Benadryl
However, my guilt didn't last long. It would seem that HB has inherited a hardy liver from his mother. Because although he did settle in for a nap about 45 minutes after his dose, the nap didn't last much longer than his usual one, at which point he awoke, extra rested for his next assault. And then we entered some turbulence. The stewardess, who was either very rules-conscious or just sadistic, insisted that the seatbelt sign applied to HB as well, and he had to be strapped into his carseat.*
And then his DVD player, which apparently was not designed to survive being repeatedly hurled to the floor, broke.
How bad did it get? So bad that we actually had notes passed up the aisle with suggestions from other passengers on how to make him shut up. And I couldn't blame them. I actually hoped someone might have a good idea. But really, all he wanted was Out. Of. This. Frickin. Seat.
There was no evidence that the Benadryl had any lasting effect whatsoever. And when we got home he wouldn't go to sleep until 11:30. I guess next time we slip him some Xanax, or on second thought, take it ourselves and then offer it around the plane.
*This highlights the weird double standard about babies and airplanes. If they're under two, they can sit on your lap. Ah, they'll be fine, just hang on to 'em. We tend to get a seat for HB anyway, since we risk bodily injury if we try to control him within the confines of our two seats. But if we buy him a seat and bring his carseat, then they get all official on our asses. First they have to check if the seat is Approved, and then they make him sit in it. WTF?
Saturday, October 22, 2005
My Breasts, or, When Are You Going to Stop ... THAT?
I entered motherhood committed to the idea of breastfeeding, and fully prepared for how much it can, well, suck. I knew it would be difficult and painful -- never mind what some rabid BF advocates say, I'd seen enough women go into it with the best attitude and support possible reduced to cringing, weeping wrecks to know that it can be really, really hard.
And it was. First the (unfounded) terror that my milk would never come in and my baby would shrivel away -- or that I would weaken and give in to the evil, evil formula supplementation and prevent my milk from coming in.
Next the (well-founded) fear of the pain. I hoarded the Percocets prescribed after my "crotch c-section" and used them prior to evening nursing sessions, which for some reason were the most painful. (Yes, I exposed my baby to narcotics. Also to alcohol, caffeine, cow's milk, and cabbage. And he's fine. Well, crabby and tiny, but fine.) I remember TrophyHusband holding the baby until he got fussy, then suggesting timidly, maybe he was hungry? He can't be hungry! I just nursed him! Figure out a way to calm him down! Sometimes I felt like I was constantly being chased around the house by my husband, the squalling baby held out in front of him like the masthead of a ship.
Then came the WWF breast-wrestling matches -- it took weeks for my "let-down" to get coordinated, during which period of time each feeding session began with the baby latching on, then letting go and howling in frustration, latching on, howling, over and over and over ... I timed it, and the average length of time it took for him to start really nursing was 20 minutes. Average. Sometimes it was 40 minutes. Including middle of the night feedings. And each feeding lasted about 45 minutes, which meant I was nursing or trying to nurse approximately 26.5 hours per day.
Finally it all clicked, stopped hurting, went smoothly and efficiently.
It was right around this time that people started asking, "How long do you plan to keep doing ... THAT?"
Geez, people. I just finally got the hang of it! Was what I wanted to say. What I really said was something along the lines of, well, it's recommended for the first six to twelve months, yadda yadda. But really I had no clue. I sort of figured it would, as we say in medicine, declare itself. He'd wean himself, or he'd start biting, or I'd get sick of it.
None of which occurred. And once the early hurdles were over, the rest didn't really bother me. Breastfeeding in public was never even the slightest issue. I've never been shy when it comes to exposing body parts, and it certainly didn't bother me to haul out a boob for a crying baby. And I've never noticed anyone appear to be bothered by it. Once when I was sitting in a public park I realized that several people were staring at me, but then I looked behind me and realized that it was a cute cat pouncing on leaves that was drawing everyone's attention. It didn't even faze me to do it in front of TrophyHusband's 80-year-old grandfather. I figure, if it makes someone uncomfortable, they can look away, and if someone gets off on it, well, I'm glad to spread some happiness in the world. There was one episode at TH's work Christmas party where AngelBaby kept popping off to look around, causing me to spray milk onto adjacent guests, but mostly it was all good.
Well, I'm remembering now, pumping at work was occasionally a hassle. I have my own office with a door that locks and my mornings are flexible, so usually it was ok (though time-consuming and messy), but one night I had to stay late so I pumped an extra time, and suddenly I heard a key turn and the door flew open and there I was, breasts laid bare, the two trumpet-like pump flanges protruding from my chest and the machine going runk-runk-runk, facing the kid who cleans the offices at night. He still averts his eyes and won't return my greeting when I pass him in the hall.
Then AngelBaby turned one and I found myself wandering around in the world of Extended Breastfeeding. It appears that without realizing it, I have become an official member of the wacko-hippie-crunchy-holier than thou CULT. At least according to some of those who stopped breastfeeding earlier. And my mother. AB is small for his age, so it's not always obvious that I'm nursing a walking, talking child, but when he toddles over, climbs into my lap, straddles my legs, yanks up my shirt and bra yelling "NUR! NUR! NUR!" and displaying his mouthful of teeth, it can cause quite a stir.
So how long am I going to keep doing ... THAT?
I still have no clue. It's so easy, and so useful -- nothing fixes a pissy mood or a smashed finger faster, and when he's being HellBoy, my boobs are the only weapons I've really got. There's no up-side to giving that up.
So how bad would it be, really, to send breastmilk care packages to my son at college? I know FedEx can ship frozen stuff.
And it was. First the (unfounded) terror that my milk would never come in and my baby would shrivel away -- or that I would weaken and give in to the evil, evil formula supplementation and prevent my milk from coming in.
Next the (well-founded) fear of the pain. I hoarded the Percocets prescribed after my "crotch c-section" and used them prior to evening nursing sessions, which for some reason were the most painful. (Yes, I exposed my baby to narcotics. Also to alcohol, caffeine, cow's milk, and cabbage. And he's fine. Well, crabby and tiny, but fine.) I remember TrophyHusband holding the baby until he got fussy, then suggesting timidly, maybe he was hungry? He can't be hungry! I just nursed him! Figure out a way to calm him down! Sometimes I felt like I was constantly being chased around the house by my husband, the squalling baby held out in front of him like the masthead of a ship.
Then came the WWF breast-wrestling matches -- it took weeks for my "let-down" to get coordinated, during which period of time each feeding session began with the baby latching on, then letting go and howling in frustration, latching on, howling, over and over and over ... I timed it, and the average length of time it took for him to start really nursing was 20 minutes. Average. Sometimes it was 40 minutes. Including middle of the night feedings. And each feeding lasted about 45 minutes, which meant I was nursing or trying to nurse approximately 26.5 hours per day.
Finally it all clicked, stopped hurting, went smoothly and efficiently.
It was right around this time that people started asking, "How long do you plan to keep doing ... THAT?"
Geez, people. I just finally got the hang of it! Was what I wanted to say. What I really said was something along the lines of, well, it's recommended for the first six to twelve months, yadda yadda. But really I had no clue. I sort of figured it would, as we say in medicine, declare itself. He'd wean himself, or he'd start biting, or I'd get sick of it.
None of which occurred. And once the early hurdles were over, the rest didn't really bother me. Breastfeeding in public was never even the slightest issue. I've never been shy when it comes to exposing body parts, and it certainly didn't bother me to haul out a boob for a crying baby. And I've never noticed anyone appear to be bothered by it. Once when I was sitting in a public park I realized that several people were staring at me, but then I looked behind me and realized that it was a cute cat pouncing on leaves that was drawing everyone's attention. It didn't even faze me to do it in front of TrophyHusband's 80-year-old grandfather. I figure, if it makes someone uncomfortable, they can look away, and if someone gets off on it, well, I'm glad to spread some happiness in the world. There was one episode at TH's work Christmas party where AngelBaby kept popping off to look around, causing me to spray milk onto adjacent guests, but mostly it was all good.
Well, I'm remembering now, pumping at work was occasionally a hassle. I have my own office with a door that locks and my mornings are flexible, so usually it was ok (though time-consuming and messy), but one night I had to stay late so I pumped an extra time, and suddenly I heard a key turn and the door flew open and there I was, breasts laid bare, the two trumpet-like pump flanges protruding from my chest and the machine going runk-runk-runk, facing the kid who cleans the offices at night. He still averts his eyes and won't return my greeting when I pass him in the hall.
Then AngelBaby turned one and I found myself wandering around in the world of Extended Breastfeeding. It appears that without realizing it, I have become an official member of the wacko-hippie-crunchy-holier than thou CULT. At least according to some of those who stopped breastfeeding earlier. And my mother. AB is small for his age, so it's not always obvious that I'm nursing a walking, talking child, but when he toddles over, climbs into my lap, straddles my legs, yanks up my shirt and bra yelling "NUR! NUR! NUR!" and displaying his mouthful of teeth, it can cause quite a stir.
So how long am I going to keep doing ... THAT?
I still have no clue. It's so easy, and so useful -- nothing fixes a pissy mood or a smashed finger faster, and when he's being HellBoy, my boobs are the only weapons I've really got. There's no up-side to giving that up.
So how bad would it be, really, to send breastmilk care packages to my son at college? I know FedEx can ship frozen stuff.
Monday, October 17, 2005
How I Became a Doctor
Mine was not the typical path to medical school. In my family, we weren't raised so much as allowed to grow up. What pressure there was, was to be creative. My mother was an artist who taught school to make ends (approximately) meet, and I always got more praise for my artistic endeavors than my good grades. (My father was a violinist who worked as a statistician to make ends meet, but he died in a motorcycle crash when I was five.) I didn't do more science classes than absolutely required. Instead I took English, French, German, creative writing, art, music ... and I decided to major in creative writing in college.
Yet all along I was fascinated by medical subjects. Really fascinated. Weirdly fascinated. I guess it started after I had a nervous breakdown at the age of fourteen following an ugly period involving a sadistic live-in boyfriend of my mother's. I developed major depression accompanied by panic attacks and anxiety, and the main focus of my anxiety was that I was dying of some dread disease. (I'm not sure why this made me so anxious, since I also wished that I would die.) It's a good thing the internet wasn't around yet, because I could have whipped myself into a nonstop frenzy looking at all the paranoid sites that exist today. What I did do was read every medical article I could find in every magazine and newspaper I could get my hands on. The nervous breakdown finally ran its course (for the time being) and the evil boyfriend left (for good), but my medical article addiction remained.
After college I got a nearly free ride to get an MFA in creative writing. It was there that I first began to realize that the creative life might not be the one for me. Because while I loved writing a really good story, I only managed to produce something I considered to be really good once or twice a year. The rest was crap. I also got fed up with the workshops. After a while I just didn't feel like commenting on yet another semi-autobiographical story of awakening. (I did make my best friend in my MFA program, and her approach to writing -- as hard work she could do for hours, days, weeks, months, years on end without much return -- made me realize that mine was dilettantish. She did ultimately become a published novelist, richly deserved.)
I went to work as an editor of technical writing, while trying to keep writing fiction on my time off. I really liked my job, but the part I most enjoyed about it was getting a project that I could dig into and know that I could finish. I began to realize that I have a hard time with delayed gratification when it comes to work. I like to know that I've done something useful every day. Creative writing is far from that kind of work. You can measure the number of words you write each day, but the chance of them being useful in some way is dauntingly tiny. Not that fiction isn't useful -- it has enlightened, encouraged, emboldened, and educated me in many ways over the years -- but I had no faith that most of what I produced would be of use. Partly because the chances of being published are slim, but also because as I said before, most of what I put out seemed like crap.
I joked from time to time that I had missed my true calling, because medicine is not a particulary good hobby. But I never seriously considered going to medical school. It seemed absurd. It was absurd. To do it, I'd have to figure out a way to do all the premed requirements; then take the MCATs; then apply to med school; then if I got in, spend four years in med school followed by at least three years of residency and then possibly fellowship. I was terrified of the idea of spending the next ten years of my life on something so grueling. I'd never been someone who could skimp on sleep; how on earth could I survive being on call? And wasn't I too old?
When I was 27, some messy painful stuff happened having to do with a man, and I found myself feeling depressed again. One day I started wondering, How did I get here? This is not my beautiful life. So I asked myself, All right, where is my beautiful life? And I thought, I wish I'd gone to medical school. What about all the objections above? Well, I thought, so it's ten years, but it's not ten years of prison. It's ten years of living, just doing something different and harder. And if I wait any longer, I'll just be older. Around the same time I inherited some money -- not a ton, but enough to let me quit my job and take premed classes for a year. Which I did.
It was pretty terrifying at first. I didn't do a prepackaged postbac year -- too expensive; I went to a state school as a special student and waitlisted myself on all the premed courses I needed. My schedule was like a complicated jigsaw puzzle. And I was rusty. I got a 39 on my first physics quiz, which made me hyperventilate. But taking all the premed courses together was actually very efficient; once I figured out how to study for one, the methods applied to all of them. And I did figure it out. Eventually I totally kicked ass on every subject.
When I interviewed at medical schools, I was worried that they'd be puzzled by me and the path I'd taken to get there. As it turned out, they loved me -- they were bored of seeing the cookie-cutter 21-year-old premeds who had never gotten a chance to do anything interesting in their lives because their parents had pushed them into medicine. And when I started med school I found that I had a real advantage over those kids. I'd already spent a summer bumming around Europe -- three summers, in fact. I'd already had my fill of waiting tables and writing fiction and hanging out and generally living the slacker life. It didn't bother me to buckle down; for me it was a refreshing change. Especially refreshing was learning something real rather than pondering the abstract.
There were some drawbacks, of course. First was the money. When I had to sign the documents to borrow the first $25,000 for the first semester, I cried. Second was the time commitment. It was indeed hard, and it left me with little time to develop the rest of my life. For instance, I didn't deal with getting rid of the boyfriend with the messy painful issues for several years, during which time my biological clock started winding down. Third was the way it transformed me. In many good ways to be sure, but I did lose some of the things I liked about myself. I'd always had a phenomenal memory, but now I no longer could remember many details of my life. I actually forgot entire events ever took place. And I was no longer as able to be supportive of other people.
Am I glad I did it? Absolutely -- it really is my beautiful life much of the time. I am so suited to being a doctor. I've always been curious about the inner workings of other people -- both physical and mental -- and medicine gives me license to actually poke around and take a look. And I found TrophyHusband during residency, which was such a stroke of good luck I could hardly believe it -- I'd pretty much resigned myself to being single, since I'd rather be single than be with someone just to get married, and I was a terrible judge of who might be right for me.
I do regret that I didn't do it slightly sooner. I urge others who are considering med school to put it off a little while, because I think being older and having more life experience was tremendously helpful, but seven years was a bit longer than I needed.
People often ask if I still write fiction. I don't. I keep waiting to see if I'll ever feel the need to express myself in that way, and so far I haven't. But clearly I feel a need to express myself in some way, because here I am.
Yet all along I was fascinated by medical subjects. Really fascinated. Weirdly fascinated. I guess it started after I had a nervous breakdown at the age of fourteen following an ugly period involving a sadistic live-in boyfriend of my mother's. I developed major depression accompanied by panic attacks and anxiety, and the main focus of my anxiety was that I was dying of some dread disease. (I'm not sure why this made me so anxious, since I also wished that I would die.) It's a good thing the internet wasn't around yet, because I could have whipped myself into a nonstop frenzy looking at all the paranoid sites that exist today. What I did do was read every medical article I could find in every magazine and newspaper I could get my hands on. The nervous breakdown finally ran its course (for the time being) and the evil boyfriend left (for good), but my medical article addiction remained.
After college I got a nearly free ride to get an MFA in creative writing. It was there that I first began to realize that the creative life might not be the one for me. Because while I loved writing a really good story, I only managed to produce something I considered to be really good once or twice a year. The rest was crap. I also got fed up with the workshops. After a while I just didn't feel like commenting on yet another semi-autobiographical story of awakening. (I did make my best friend in my MFA program, and her approach to writing -- as hard work she could do for hours, days, weeks, months, years on end without much return -- made me realize that mine was dilettantish. She did ultimately become a published novelist, richly deserved.)
I went to work as an editor of technical writing, while trying to keep writing fiction on my time off. I really liked my job, but the part I most enjoyed about it was getting a project that I could dig into and know that I could finish. I began to realize that I have a hard time with delayed gratification when it comes to work. I like to know that I've done something useful every day. Creative writing is far from that kind of work. You can measure the number of words you write each day, but the chance of them being useful in some way is dauntingly tiny. Not that fiction isn't useful -- it has enlightened, encouraged, emboldened, and educated me in many ways over the years -- but I had no faith that most of what I produced would be of use. Partly because the chances of being published are slim, but also because as I said before, most of what I put out seemed like crap.
I joked from time to time that I had missed my true calling, because medicine is not a particulary good hobby. But I never seriously considered going to medical school. It seemed absurd. It was absurd. To do it, I'd have to figure out a way to do all the premed requirements; then take the MCATs; then apply to med school; then if I got in, spend four years in med school followed by at least three years of residency and then possibly fellowship. I was terrified of the idea of spending the next ten years of my life on something so grueling. I'd never been someone who could skimp on sleep; how on earth could I survive being on call? And wasn't I too old?
When I was 27, some messy painful stuff happened having to do with a man, and I found myself feeling depressed again. One day I started wondering, How did I get here? This is not my beautiful life. So I asked myself, All right, where is my beautiful life? And I thought, I wish I'd gone to medical school. What about all the objections above? Well, I thought, so it's ten years, but it's not ten years of prison. It's ten years of living, just doing something different and harder. And if I wait any longer, I'll just be older. Around the same time I inherited some money -- not a ton, but enough to let me quit my job and take premed classes for a year. Which I did.
It was pretty terrifying at first. I didn't do a prepackaged postbac year -- too expensive; I went to a state school as a special student and waitlisted myself on all the premed courses I needed. My schedule was like a complicated jigsaw puzzle. And I was rusty. I got a 39 on my first physics quiz, which made me hyperventilate. But taking all the premed courses together was actually very efficient; once I figured out how to study for one, the methods applied to all of them. And I did figure it out. Eventually I totally kicked ass on every subject.
When I interviewed at medical schools, I was worried that they'd be puzzled by me and the path I'd taken to get there. As it turned out, they loved me -- they were bored of seeing the cookie-cutter 21-year-old premeds who had never gotten a chance to do anything interesting in their lives because their parents had pushed them into medicine. And when I started med school I found that I had a real advantage over those kids. I'd already spent a summer bumming around Europe -- three summers, in fact. I'd already had my fill of waiting tables and writing fiction and hanging out and generally living the slacker life. It didn't bother me to buckle down; for me it was a refreshing change. Especially refreshing was learning something real rather than pondering the abstract.
There were some drawbacks, of course. First was the money. When I had to sign the documents to borrow the first $25,000 for the first semester, I cried. Second was the time commitment. It was indeed hard, and it left me with little time to develop the rest of my life. For instance, I didn't deal with getting rid of the boyfriend with the messy painful issues for several years, during which time my biological clock started winding down. Third was the way it transformed me. In many good ways to be sure, but I did lose some of the things I liked about myself. I'd always had a phenomenal memory, but now I no longer could remember many details of my life. I actually forgot entire events ever took place. And I was no longer as able to be supportive of other people.
Am I glad I did it? Absolutely -- it really is my beautiful life much of the time. I am so suited to being a doctor. I've always been curious about the inner workings of other people -- both physical and mental -- and medicine gives me license to actually poke around and take a look. And I found TrophyHusband during residency, which was such a stroke of good luck I could hardly believe it -- I'd pretty much resigned myself to being single, since I'd rather be single than be with someone just to get married, and I was a terrible judge of who might be right for me.
I do regret that I didn't do it slightly sooner. I urge others who are considering med school to put it off a little while, because I think being older and having more life experience was tremendously helpful, but seven years was a bit longer than I needed.
People often ask if I still write fiction. I don't. I keep waiting to see if I'll ever feel the need to express myself in that way, and so far I haven't. But clearly I feel a need to express myself in some way, because here I am.
Sunday, October 16, 2005
Oh Boy, Here We Go: The CIO Missionary
My sister-in-law has a son who is six months younger than HellBoy. He's also already two pounds heavier (we get his hand-me-downs). He's a fat, blond, happy happy happy baby. Put the two of them next to each other, and HB looks like a worried gnome.Until now, our styles of baby raising had been fairly similar -- breastfeeding, some cosleeping, lots of carrying around. But the two babies' temperaments are very different -- I've never actually seen PerfectCousin cry, while on bad days HB uses screaming as his main means of communication.
But my SIL hasn't been getting much sleep, and last week she tried letting PC cry it out. As it often does, it worked within two days, and now he doesn't wake them up at night. I'm truly happy for them; I'm glad she is no longer so sleep-deprived.
But now SIL is proselytizing for the CIO method. She's calling us up every other day insisting that we have to do it too. "I just want you to get sleep too!" she says. I've told her that in fact I feel quite rested most days, and that the main person in our house who needs to have improved sleep habits is me -- I've always tended to wake up in the middle of the night and wander the house waiting to feel sleepy again. (Despite having been a CIO baby myself.)
I've never told anyone they shouldn't use CIO, and I don't think I project an aura of disapproval, either. I don't think it's evil. I just don't want to do it with HB. So why does everyone want to convert me? I'm starting to know how smokers feel.
Wednesday, October 12, 2005
The Talk
TrophyHusband and I had The Talk the other night. The Talk about whether we want another child, and if so, where to get one.
We agree that yes, another child is theoretically something we both want. So far so good.
The problem is where to get this child. Options include:
We agree that yes, another child is theoretically something we both want. So far so good.
The problem is where to get this child. Options include:
- Go back to the ART clinic and see if another few go-rounds with IVF yield anything.
Pros: Might get another bio kid, resulting in a matched set; no arduous adoption process.
Cons: Much less likely to work now than last time given my age; the time, energy, and cost; pregnancy; birth; the cold sweat and palpitations I get remembering the needles, the probes, the walking around throbbing with rage at anything and everything when my estradiol level goes above 1000. - Donor eggs.
Pros: TrophyHusband's mensch-y genes; no arduous adoption process; get a baby from birth.
Cons: End up with a hard-to-explain half-matched set of kids; cost; pregnancy; birth. - Adoption.
Pros: Could choose the sex; no pregnancy; no birth.
Cons: The whole arduous process; cost; not having the baby from birth; and, where to adopt from? The open-adoption circuit is out -- I watched my sister go through that and I know I couldn't take the uncertainty. So that leaves non-white babies. TH's stepfather is African-American, which makes this question even more delicate in our family. I'm not sure I'd be able to watch one of my children be discriminated against. But would we seem racist if we chose to adopt internationally?
Thursday, October 06, 2005
I'm Hiding Out Over Here
Holy cow are things heating up over at the Leery Polyp. I didn't comment, partly because there are too many words there already, but partly because it doesn't seem like a discussion that includes people like me. I haven't read all of the comments (I don't have time for a third full-time job), but from what I saw, the discussants fell into two camps: the I Gave Birth Through My Vagina Without Drugs and I Am Proud camp, and the I Couldn't Give Birth Through My Vagina and I Am Hurt that You Are Proud camp.
Where's my camp? The I Gave Birth Through My Vagina With Drugs and Had a Terrible Tear and Still Am in Pain and Wish I'd Had the Damn C-Section but Really Don't Mind if You're Proud camp?
From the research I've done, in the days before modern medicine when women gave birth at home without drugs, very few women died. But a lot of babies did, or were damaged. Birth plans are really for the mother, not the baby. Yes, babies born by uncomplicated vaginal births with minimal drugs do very slightly "better" at the beginning, but this effect is small and transient. And babies born by complicated vaginal births do much worse than those born by c-section, and these effects can be large and permanent. And it's very hard to predict which way things will go. (I've always been intrigued by the stories of girls who give birth in secret and then go back to the prom -- how do they have such an easy time of it? But one of my best friends is an OB, and she's seen several such mothers after the births. She said usually the perineum is a wreck after these deliveries, and extremely hard to repair.)
Women who sense that OBs are resistant to their birth plans are usually correct. But this is because if the result of a delivery is not a healthy baby, the OB is the one who will be blamed/sued/devastated. Hardly any of my students want to go into OB now; it's not worth it.
But I'm way too chickenshit to post this over at Jo's.
Where's my camp? The I Gave Birth Through My Vagina With Drugs and Had a Terrible Tear and Still Am in Pain and Wish I'd Had the Damn C-Section but Really Don't Mind if You're Proud camp?
From the research I've done, in the days before modern medicine when women gave birth at home without drugs, very few women died. But a lot of babies did, or were damaged. Birth plans are really for the mother, not the baby. Yes, babies born by uncomplicated vaginal births with minimal drugs do very slightly "better" at the beginning, but this effect is small and transient. And babies born by complicated vaginal births do much worse than those born by c-section, and these effects can be large and permanent. And it's very hard to predict which way things will go. (I've always been intrigued by the stories of girls who give birth in secret and then go back to the prom -- how do they have such an easy time of it? But one of my best friends is an OB, and she's seen several such mothers after the births. She said usually the perineum is a wreck after these deliveries, and extremely hard to repair.)
Women who sense that OBs are resistant to their birth plans are usually correct. But this is because if the result of a delivery is not a healthy baby, the OB is the one who will be blamed/sued/devastated. Hardly any of my students want to go into OB now; it's not worth it.
But I'm way too chickenshit to post this over at Jo's.
Wednesday, October 05, 2005
The Center Cannot Hold
So despite the stealth ibuprofen, AngelBaby did get a fever, and was banished from daycare. His illness has a domino effect:
- Our dinner with the people from New Orleans had to be postponed
- TrophyHusband has to stay home with AB, and had to cancel his Thursday 6am deal
- I have a plausible excuse for skipping the leadership class
Friday, September 30, 2005
Weekly Wrap-Up
AngelBaby had his 15 month check-up this am, and we found that:
The nurse practitioner has been concerned because he's had fluid in his ears at every visit, plus two ear infections last spring. But we took him for a hearing eval a couple of weeks ago, which he passed with flying colors, so we thought the issue was settled. But today she noted fluid again (no, really?), and wants to check with ENT about tube placement.
I think this could be described as elective surgery for nurse practioner distress. We're not biting.
In other news, I've been talking with my brother's girlfriend and her dad almost daily. Her mom has a pretty bad cancer, it turns out. They're wonderful people. Of course. Sucks.
In more other news, I'll be on call from 4:30 pm today until 8:30 am Monday. Fortunately one set of TrophyHusband's parents are coming for the weekend to pitch in with HellBoy. I am very lucky in the in-law category.
- He remains in the 5th percentile for weight
- He remains in the 10-25th percentile for height
- His head remains in the 75th percentile
The nurse practitioner has been concerned because he's had fluid in his ears at every visit, plus two ear infections last spring. But we took him for a hearing eval a couple of weeks ago, which he passed with flying colors, so we thought the issue was settled. But today she noted fluid again (no, really?), and wants to check with ENT about tube placement.
I think this could be described as elective surgery for nurse practioner distress. We're not biting.
In other news, I've been talking with my brother's girlfriend and her dad almost daily. Her mom has a pretty bad cancer, it turns out. They're wonderful people. Of course. Sucks.
In more other news, I'll be on call from 4:30 pm today until 8:30 am Monday. Fortunately one set of TrophyHusband's parents are coming for the weekend to pitch in with HellBoy. I am very lucky in the in-law category.
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